January 14 - May 10
Clement Arts: Westminster Campus
2303 Double Churches Rd
Columbus, GA 31909
Your participation helps Clement Arts support foster and adoptive families in our community. Thank you!
Please supply information for each student you'd like to register. You can register up to three students for music classes on this form. Please fill out an additional registration form if you are registering more than three students.
Does your child have prior music experience? Describe briefly.
Does your child have any known allergies or dietary restrictions?
Does your child have any known learning or behavioral diagnosis? This information is kept confidential and only used to help us better serve and instruct your child.
I/we have chosen to have my/our child participate in music instruction given by Clement Kids Music. I acknowledge that I understand the nature of the activities my child will be participating in and the possibility that despite precautions, accidents and/or physical injury may occur.
I/we agree to release and hold harmless Clement Kids Music and Clement Arts, including its teachers, and staff members from any cause of action, claims, or demands now and in the future. I/we will not hold any of the above liable for any personal injury or any personal property damage or loss, which may occur on the premises before, during, or after classes or which may occur at any Clement Kids Music sponsored event outside the studio.
Furthermore, I/we agree to take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by Clement Kids Music.
I authorize and agree that Clement Kids Music may take and use photographs, videos, or likenesses of myself or my child as needed for its record keeping, advertising, social media and/or public relations projects and that I have no rights to the same and will not be compensated for the same.
(An invoice will be sent to you soon. Please allow time for the invoice to be sent.)
Registration fees must be paid for each student.
Visa®, Mastercard® & Discover® cardholdersYour security code is the 3-digit code at the end of the signature field on your card's back.
American Express® cardholdersYour security code is the 4-digit code located above the actual credit card number on your card's front.